title: Predictors for achieving protein and energy requirements in undernourished hospital patients.
abstract: OBJECTIVE
  Providing sufficient protein an energy is considered crucial in the treatment of undernutrition. Still, the majority of undernourished hospital patients have a suboptimal protein and energy intake. The aim of this study was to investigate predictors for achieving protein and energy requirements on the fourth day of admission in undernourished hospitalized patients.
  
  
  METHODS
  830 adult undernourished patients (SNAQ ≥ 3) were retrospectively included. Intake requirements were defined as ≥1.2 g protein per kg bodyweight and ≥100% of the energy requirement based on calculated resting energy expenditure according to Harris & Benedict + 30%. Logistic regression analyses were performed to investigate predictors for achieving the requirements.
  
  
  RESULTS
  Protein and energy intake had been recorded for 610 patients, of whom 25.6% had sufficient protein and energy intake. Protein requirements were less commonly met than energy requirements. Complete case analyses (n = 575) showed that negative predictors for achieving the protein and energy requirements were: nausea (OR = 0.18; 95%CI = 0.06-0.53), cancer (0.57; 0.35-0.93), acute infections (0.63; 0.37-1.01) and higher BMI (0.84; 0.79-0.89). Positive predictors were: a higher age (1.01; 1.00-1.03), chronic lung disease (3.76; 2.33-6.07) and receiving tube feeding (3.89; 1.56-9.73).
  
  
  CONCLUSIONS
  Only one in four undernourished hospital patients meets the predefined protein and energy requirements on the fourth day of admission. Nausea, cancer, acute infections, BMI, age, chronic lung disease and tube feeding were identified as predictors for achieving protein and energy intake.
authors.affiliation: Department of Nutrition and Dietetics, Internal Medicine and the EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands. e.leistra@vumc.nl
authors.forename: Eva
authors.initials: E
authors.lastname: Leistra
authors.forename: Floor
authors.initials: F
authors.lastname: Willeboordse
authors.forename: Marian A E
authors.initials: MA
authors.lastname: van Bokhorst-de van der Schueren
authors.forename: Marjolein
authors.initials: M
authors.lastname: Visser
authors.forename: Peter J M
authors.initials: PJ
authors.lastname: Weijs
authors.forename: Annelie
authors.initials: A
authors.lastname: Haans-van den Oord
authors.forename: Jan
authors.initials: J
authors.lastname: Oostenbrink
authors.forename: Anja M
authors.initials: AM
authors.lastname: Evers
authors.forename: Hinke M
authors.initials: HM
authors.lastname: Kruizenga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000178:diet therapy / Q000453:epidemiology*; D008875:Middle Aged; D009751:Nutritional Requirements; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D004044:Dietary Proteins